Maxillary Central Incisor Implants: Solve Esthetic Problems?

I inherited this case from another dentist who placed and restored the two maxillary central incisors. Implants were placed 8/30/17 and are 3.3x13mm.  They are 1mm sub-crestal and were placed using a surgical guide. Basically when the doctor placed the cement retained crowns he told the patient that the gingiva would mature and fill in over the next year (That was in 12/20/17).

I last saw the patient in April of 2018. Patient is very concerned about the black triangles between 11 and 21 implants.

I am just wondering what is the best way to proceed? I cannot change where the implants were placed. But I could try doing a connective tissue graft or adding pink porcelain to the crowns but I feel that would be a really unaesthetic way to solve the problem. Thoughts?



6 thoughts on “Maxillary Central Incisor Implants: Solve Esthetic Problems?

  1. Leatha J Wood says:

    I’d like to see photographs of the actual crowns and black triangles.

    My first thought would be to place fillers into the papilla to work on minimizing the black triangles.

    (0)
  2. DrAZ says:

    Tough to recommend anything without photographs. Depending on lip line, I would consider connecting implants on 8-9 with crowns/ pink porcelain. Your fighting an uphill battle and what looks good now will turn on you a few months down the road.

    (0)
  3. Matt Helm DDS says:

    I agree with all the above posters that without photographs no true opinion can be formed. I, too, would like to actually see the black triangles between 11 and 21 that you describe. I am assuming that they are formed on either side by the incisal papilla and the implants, meaning the incisal papilla between 11 and 21 is incompletely formed. Interdental papillae can be somewhat modeled with the interproximal contours (the emergence profile) of the temp crowns in some cases. Not sure that this is the case, but worth noting. In principle I am not for pink porcelain since it never renders a natural look, especially in this very demanding area. Please upload some photos, with the lip retracted and with the patient’s natural smile line.

    (0)
  4. Dr R Y says:

    Same here, I would like to see black triangle area in photographs with clear vision and if you have panoramic view as well.

    (0)

Leave a Comment:

Comment Guidelines: By posting comments you agree to accept our Terms of Use, Disclaimer and Privacy Policy. For more details, read our comment guidelines. Though we require an email to comment, we will NEVER publish your email.
Required fields are marked *

Posted in Clinical Cases, Restorative.
Bookmark Maxillary Central Incisor Implants: Solve Esthetic Problems?

Videos to Watch:

Single Tooth Replacement with Implants in the Esthetic Zone

Dr. Jack Hahn provides tips and reviews cases for implant placement in the esthetic zone.[...]

Watch Now!
Surgical Consideration for the Flapless Approach

In this video, Dr. Jack Hahn discusses and presents cases to review the surgical considerations[...]

Watch Now!
Bond Apatite: Socket Preservation Cases

These 2 videos show the use of Bond Apatite in socket preservation cases, one with[...]

Watch Now!
3D Guided Implant Placement

The placement of multiple implants in this case was helped thru the use of 3d[...]

Watch Now!
Ridge Splitting Cases in Narrow Alveolar ridge

This videos shows ridge splitting, which when combined with bone expansion, is an effective technique[...]

Watch Now!
Placement of 4 Implants and Cement-Retained Bridge

The treatment plan was to extract the lower incisors, canines, and lower premolar and place[...]

Watch Now!
Failing Bridge Replaced with Dental Implant Supported Bridge

Ahe patient presented with a failed dental bridge from the upper right canine to the[...]

Watch Now!
Lateral Sinus Augmentation with CGF

Following membrane elevation with the lateral approach, and confirmation of an intact sinus membrane, concentrated[...]

Watch Now!
Titanium Mesh for Ridge Augmentation

The use of titanium mesh is a reliable method for ridge augmentation to provide adequate[...]

2 Comments

Watch Now!
Implant Grafting Techniques: Demineralized Sponge Strip and Tunneling

This video reviews several unique grafting and surgical techniques, including the use of demineralized cancellous[...]

Watch Now!
Mandibular Fixed Screw Retained Restoration

This video shows the use of a surgical guide for a mandibular fixed screw retained[...]

1 Comment

Watch Now!
Clinical Tip for Fixation of a Collagen Membrane

This video provides a clinical tip with regards to the fixation of a collagen membrane.[...]

Watch Now!